Monthly Archives: February 2016

Introduction

What have the Scots ever done for us? The answer is a candid ‘quite a lot‘. Over the last few centuries we have been indebted to many remarkable, but often unsung, Scottish scientists and innovators for improving the quality of our lives.

However, despite such unfavourable evidence emerging over the last decade or so, the chiropractic profession in the UK continues to enjoy the automatic respect and benefits lent to it by statutory regulation and a Royal Charter that was awarded to its foremost professional membership body despite that body failing to fully comply with the requirements set out by the UK Government’s Privy Council. As if such spurious legitimacy wasn’t enough, it now looks like a further storey is about to be added to this healthcare house-of-cards in the form of the ‘Scotland College of Chiropractic’.

The Italian Job

Life University has already been negotiating a partnership with the Italian Chiropractic Association in Rome, Italy, with the purpose of offering a Doctor of Chiropractic degree. As a branch campus of Life University in Italy, offering an identical curriculum, its accreditation (recognition) would be through the U.S. Council of Chiropractic Education and the Southern Association of Colleges and Schools. This set up would allow Life University students to study for their degrees in Italy while continuing to have access to US federal financial benefits. According to the 2015 Fall edition of Life University’s Your Extraordinary LIFE magazine, the Italian campus is scheduled to open in 2018. In the interim, having confessed that it is “barely graduating enough DCs (Doctors of Chiropractic) to replace those retiring or passing away”, Life University is busy forging other partnerships which, like the new campus in Italy, appear to fall under its Global Initiatives programme, which harvests educational institutions “that recognize the value and vision of building sustainable partnerships around the world”. These partnerships are based “on the Vitalistic paradigm that drives the entire University“, and will benefit from ‘Presidential International Initiative Scholarships’ that are “awarded in key areas of the world where recipients must return to their home country to further develop our partnership goals in order to promote chiropractic philosophy internationally”. Notably, a trade body, the Scottish Chiropractic Association, already offers Life University scholarships, no doubt in full knowledge that chiropractors who have graduated from Life University who wish to work as chiropractors in the UK need only pass a Test of Competence to achieve registration with the UK statutory regulatory body, the General Chiropractic Council. But more about the Test of Competence later.

Scenario 1: Escaping UK jurisdiction?

It could be that the Scotland College of Chiropractic is hoping to circumvent the need for GCC accreditation via its association with Life University. This is because, in the UK, if a course is not validated by any recognised body, it can be offered by a foreign university:

Foreign universities may offer degrees in the UK provided they make it clear that they are not UK degrees. The UK authorities cannot advise on the quality of these courses. It is up to you to check what recognition arrangements exist in the country of origin for any degree course you undertake in the UK.

However, it carries this caveat:

It is an offence in the UK for any organisation to offer a degree qualification which could be taken to be that of a UK institution unless the body making the offer is recognised by the UK authorities. The relevant legislation in this area is section 214 of the Education Reform Act 1988. Organisations suspected of committing an offence under this Act will be reported to the appropriate local Trading Standards Department for investigation. This could lead to prosecution.

It is not an offence for overseas organisations to offer their own awards in the UK, as long as they make it clear that they are not qualifications from a UK institution and that accreditation is from overseas. However, the UK authorities are unable to vouch for the quality of these qualifications, many of which may involve no formal study. UK employers are familiar with bona fide UK universities and colleges and will easily detect a bogus degree.

As with the SCA scholarships mentioned above, it’s likely that if the Scotland College of Chiropractic graduated students from the UK (as well as US students), they would only have to pass the GCC’s Test of Competence if they wished to work in the UK. (Looking further to the future, if Scotland eventually voted for independence it’s very possible that Scottish chiropractors would lobby the Scottish Government to create a sympathetic Scottish chiropractic regulatory body, the foundations for which may have been laid already.)

Scenario 2: Recognising nonsense?

But what if it isn’t permissible for the Scotland College of Chiropractic to be validated by Life University? As we already know, a UK chiropractic educational body awarding a qualification must have its programmes validated by a UK-recognised higher education institution, and then have the GCC accredit it. In this scenario, would there be a UK university prepared to validate an educational establishment with such unscientific leanings? The answer seems to be yes. Using its current Degree Recognition Criteria,the GCC has seen fit to accredit the controversial, BPP University validated McTimoney College of Chiropractic, even although the college is far from science-friendly.

Conflicting views on chiropractic standards in Europe

Ironically, however, one chiropractic standard-setting organisation, the European Council on Chiropractic Education (ECCE), an autonomous organisation established by chiropractors and with no statutory powers, has been hesitant to accept the philosophy-based chiropractic element into its ranks. In 2015, it refused a request for accreditation from the McTimoney College of Chiropractic, condemning the college’s philosophical orientation and questionable techniques and approaches to evidence in a 39-page report. McTimoney students fired back with a 17-page open letter to the ECCE in which they:

questioned “the role of any organisation that singles out philosophies, techniques and/or approaches”

questioned “the right of the ECCE to exclude accreditation based on philosophical preference” especially when its legal accreditor, the GCC, had approved them “with high levels of commendation” in its 2013 inspection

questioned the rationale behind the ECCE’s comment (see 4.2.2a of the ECCE report) that the ‘scientific level of staff does not appear to be at an appropriate level for the school to teach the principles of logic (biological plausibility) and evidence of clinical practice’

freely admitted that the McTimoney College of Chiropractic was set up “to teach traditional (Palmer style) chiropractic with a more traditional style philosophy”, with an approach “developed organically…in the belief that more specific adjustments…enabled the practitioner to use less force to achieve similar goals”, although it remained “something that is considered fluid, even if it taught with a degree of ordering”

declared that “a weakness based on our philosophy is hugely disrespectful”

stated that the ECCE appeared “to be questioning the authority of statutory powers”

The fear behind the McTimoney students’ defensive response almost certainly originates in well-founded suspicions that the ECCE wants to have chiropractic fully accepted by conventional medicine by outlawing (arguably less arduous) pseudoscientific practices.

Bringing the above ECCE accreditation issues up to date, in December 2015 the McTimoney College of Chiropractic learned that an appeal that it had launched against the ECCE’s refusal to accredit it had been successful on the grounds of:

failure to be fair and accurate

failure to be objective; and bias or apparent bias

The Appeal Panel’s report has now been sent to the ECCE’s Commission on Accreditation for them to review their decision in the light of the Appeal Panel’s findings. If the ECCE’s accreditation commission does ultimately approve accreditation for the McTimoney College of Chiropractic, it will serve to further condone chiropractic quackery that is already rife in Europe. It remains to be seen if the ECCE will accredit the Scotland College of Chiropractic, but the current ECCE status of the McTimoney College of Chiropractic and the Barcelona College of Chiropractic can be monitored here.

Returning to the subject of the GCC and its apparent leniency in recognising the education standards of a chiropractic college with a traditional ‘philosophical preference’, why might this be? Evidently, it’s because it doesn’t have a sound knowledge of chiropractic — ie its early history, chronic in-fighting, and very shaky evidence base. For instance, its legislative framework doesn’t cover the scope of chiropractic practice and, in 2015, it admitted to having no detailed information (p.14) about the make up of the UK chiropractic profession and its registrant base. Due to this ignorance, it would seem that UK chiropractors have managed, entirely unimpeded, to always elect a good proportion of subluxationist chiropractors (i.e. chiropractors who don’t seem to have a problem with vitalistic dogma) as serving members on the GCC’s committees. The most prominent of these chiropractors has been Christina Cunliffe, a graduate of the McTimoney College of Chiropractic, who is now Principal of it, and who has served on the GCC’s Education Committee. You can learn more about her style of chiropractic here where, in an unflattering investigation, it is described as ‘a cult within a cult’.

Holding similar philosophies to Christina Cunliffe is the founder of the Scotland College of Chiropractic, Ross McDonald, who graduated from this UK chiropractic college, and who appears to have been influencing the GCC for some time through a variety of channels:

He is one of the leaders of the several hundred-strong Alliance of UK Chiropractors (AUKC), the largest vitalistic body of chiropractors in the UK, comprising members of the McTimoney Chiropractic Association, the Scottish Chiropractic Association, and the United Chiropractic Association.

Talking the ToC

As an executive of the AUKC, one of Ross McDonald’s most recent attempts to influence the GCC was in a letter to it from the AUKC (see pages 11-15) that he co-signed. The letter informed the GCC of the AUKC’s vote of no-confidence in its new Test of Competence (ToC) process which, as previously mentioned, is the route to GCC registration for chiropractors who haven’t been trained via a GCC-accredited establishment in the UK. Indeed, the letter clearly shows the AUKC to be deeply agitated about the new ToC’s evidence-based line of questioning. But that’s understandable, not least because Ross McDonald might want to lessen the need for his future students to swot up on non-vitalistic educational materials in order to pass the ToC. Of particular concern is item 7 in the AUKC’s letter that takes exception to the GCC examining panel’s cautious views on taking x-rays in clinical practice. The AUKC claim:

One of the indications for requiring radiographic examination is the presence of neurological signs or symptoms. A subluxation (or any other name they wish to call it) by nature has a neurological component. Presence is an indication for x-rays (amongst other reasons).

In response to the AUKC’s letter (see C-180615-4, page 5), the Chair of the GCC’s Education Committee said that the Committee was “of the view that the new ToC system was proportionate and reflective of other regulators’ approaches”, and confirmed that there would be an internal review of the ToC at the end of one year, and an external review at the end of three years. Unfortunately, the Chair made no reference to chiropractic ‘subluxations’, which, as we already know, the GCC links to ‘health concerns’ (albeit indirectly). With this in mind, the outcome of the internal and external reviews of the GCC’s ToC will make for interesting reading. (NB. In 2007, the GCC reported (p.13) that one of its expert witnesses claimed that chiropractic ‘subluxations’ were “commonplace to the point of universality in patients”.)

Bumbling bureaucrats and bogus treatments

With the GCC taking an apologist stance on the subject of chiropractic subluxations, it should come as no surprise that its Chief Executive Officer and Registrar, David Howell, seems to have been caught up in the vitalistic chiropractic agenda that’s gathering steam in Scotland. For instance, he attended the Scottish Chiropractic Association’s AGM in October 2015. Ostensibly, his presence there was to update the Scottish Chiropractic Association’s members on the General Chiropractic Council’s activities. However, a ‘Dr’ Tim O’Shea, one of two American vitalistic chiropractors who were guest presenters at the event, blogged enthusiastically about his thoughts on it, revealing that it descended into a late night, whisky-fuelled affair in which David Howell’s loquaciousness had left him with the distinct impression that the GCC’s highest office “did not require a detailed knowledge of the profession that it regulated”. Others feel much the same.

Conclusion

In view of Scotland’s fine reputation for medical advancement, it’s disappointing that the Scotland College of Chiropractic seems intent on helping to compromise those hard-won achievements by dragging healthcare back to a time when, in a hopeless attempt to resolve health problems, superstition and religious ritual were the order of the day. Only robust regulation can stop a pernicious slide towards a culture that’s indifferent to quackery. It will mean ensuring that relevant legislators are thoroughly acquainted with The Scientific Method. Most crucially, in order for patients and the public to be truly protected, not only will transparency have to be paramount, but the inevitable backlash from chiropractors whose livelihoods will have to be earned under a defined, evidence-based scope of practice will have to be met with a persistent and conscionable resistance that firmly conveys an intolerance of double standards.

The VitalisTIC ChiropracTIC Movement is NOW bigger than ever. Get on The Quantum Train or Hang out at the Educated Station.

There is, of course, not a jot of scientific evidence for chiropracTIC, but no doubt chiropractors who aren’t dedicated to the realities of science will be more than happy to place their trust in the Scotland College of Chiropractic and its associates. However, potential students should seriously consider doing the exact opposite. They need to ask themselves if there’s a good chance that they would be wasting their time and money, and risking harm to themselves, and others, in pursuing a career in which they could find out too late that spines aren’t the only things that can be manipulated for a fee.